Communication

Introduction

The word communication is derived from the Latin word “communis”, meaning “to share,” and refers to the sharing of ideas, concepts, feelings, and emotions. It is a two-way process of exchanging and shaping information, thoughts, and feelings, enabling mutual understanding. Broadly, communication encompasses the countless ways humans keep in touch with one another.

Communication is more than the mere exchange of information; it is a process essential for bringing about desired changes in human behavior and promoting informed participation of individuals and communities to achieve predetermined goals. In recent years, it has evolved into an interdisciplinary science, drawing richly from the social sciences.

With the advent of new communication methods and the explosion of information, human mental development has expanded significantly, allowing clearer thinking, better social interaction, and improved inter-sectoral coordination.

Definitions of communication

“A process by which information is exchanged between individuals through a common system of symbols, signs or behaviors” (Merriam-Webstar)

Communication is a process of passing information and understanding from one person to another.  (Keith Davis)

Communication is an exchange of ideas, facts, opinions or emotions of two or more persons. (William Newman and Charles Summer)

Purposes of communication

1. To motivate people to act, change, adapt, and achieve the desired results.
2. To establish and disseminate the goals of an enterprise.
3. To develop plans for the achievement of those goals.
4. To organize human and other resources in the most effective and efficient way.
5. To lead, direct, motivate, and create a climate in which people want to contribute.
6. To control and evaluate performance.

Importance of communication

• Communication promotes motivation by informing and clarifying the employees about the task to be done, the manner they are performing the task and how to improve their performance if it is not up to the mark.
• Communication is a source of information to the organizational members for decision making process as it helps identifying and accessing alternative course of actions.
• Communication also plays a crucial role in altering individual’s attitude than a less-informed individual. Organizational magazines, journals, meetings and various other forms of oral and written communication help in moulding employee’s attitudes.
• Communication also helps in socializing. In today’s life the only presence of another individual fosters communication. It is also said that one cannot survive without communication.
• Communication also assists in controlling process. It helps controlling organizational member’s behavior in various ways.
•  There are various levels of hierarchy and certain principles and guidelines that employees must follow in an organization. They must comply with organization. They must comply with organizational policies, perform their job role efficiently and communicate any work problem and grievance to their superiors.

Component/elements of communication

Communication which is the basis of human interaction is a complex process. It has the following main components:

1. Sender
2. Encoding
3. Message
4. Channel
5. Receiver
6. Decoding
7. Feedback
8. Noise

Component/elements of communication

Communication which is the basis of human interaction is a complex process. It has the following main components:

1. Sender

The person who conveys a message with the intention of sharing information, ideas, or feelings with others is called the sender or communicator.

To be an effective communicator, he or she should:

• Have clear and well-defined objectives
• Possess good knowledge of the subject
• Show interest and enthusiasm in the topic
• Understand the audience and build a good rapport with them
• Communicate at the receiver’s level of understanding
• Select the most appropriate communication channel for the message.

2. Encoding

Since the message or subject matter in communication is abstract and intangible, it needs to be converted into understandable symbols before being transmitted. These symbols may include words, gestures, actions, pictures, or signs. Encoding reflects the sender’s perception and interpretation of the message. The sender encodes the ideas into a meaningful form before sending it through an appropriate communication channel

3. Message

A message is the content or information that the communicator wants the audience to receive, understand, accept, and act upon. It can be expressed through words, pictures, signs, or other symbolic forms.

In health communication, failure often occurs when the message is unclear or inadequate.

A good message should be:

• aligned with the communication objective(s)
• meaningful to the audience
• based on their felt needs
• clear and easy to understand
• specific and accurate
• timely and sufficient
• appropriate for the target audience
• interesting and engaging
• culturally and socially acceptable

Delivering the right message to the right people at the right time is essential for effective communication.

4. Channel(s)

A channel refers to the physical bridge or medium through which the message travels from the sender to the receiver. It is the pathway that carries the encoded message so that the receiver can perceive and understand it.

Media systems

The overall communication process relies on three major media systems:

• Interpersonal communication – direct, face-to-face interaction between the sender and the receiver.
• Mass media – communication delivered through widely reaching platforms such as television, radio, newspapers, magazines, and other printed or electronic media.
• Traditional or folk media – culturally rooted forms of communication such as folk dances, songs, stories, and dramas, commonly used in community settings.

5. Receiver

All communications must have an audience; this may be a single person or a group of people. Receiver is the person who receives the message or for whom the message is meant for. Message should be delivered to the receiver according to their level of understanding, age, interest, education level, culture, belief etc.

The receiver should:

• Be aware, interested and willing to accept the message
• Listen attentively
• Understand the value of message
• Provide feedback

6. Decoding

The process of translating message to be understandable by receiver is decoding. The person who receives the message or symbol from the communicator tries to convert the same in such a way to that they may extract its meaning

7. Feedback

It is the flow of information from the audience to the sender. It is the reaction of the audience to the message. If the message is not clear or otherwise not acceptable the audience may reject it outright. The feedback thus provides an opportunity to the sender to modify his message and render it acceptable.

8. Noise

It refers to any obstruction that is caused by the sender, message or receiver during the process of communication. For example, bad telephone connection, faulty encoding, faulty decoding, inattentive receiver, poor understanding of message due to prejudice or inappropriate gestures, etc.

Types of communications

1. Based on communication channel

a. Verbal communication

Uses words for exchanging messages. It may be:

• Oral – face-to-face interview, discussions, telephone calls, teaching
• Written – reports, letters, prescriptions, posters, pamphlets

Features: quick, direct, allows clarification, may carry emotional tone.

b. Non-verbal communication

Communication without words. Includes:

• Gestures
• Posture
• Facial expressions
• Eye contact
• Appearance
• Touch

Importance: supports verbal message, expresses emotion, builds trust.

2. Based on style and purpose

a. Formal communication

Official, structured communication following rules and hierarchy.
Examples: reports, memos, circulars, nursing documentation.

b. Informal communication

Casual, spontaneous communication.
Examples: friendly talks among staff, informal group chats.

3. Based on participation level

a. One-way communication (Didactic method)

Message flows only from sender to receiver.
Examples: lecture, TV, radio.
Limitations: no feedback, less effective for behaviour change.

b. Two-way communication (Socratic method)

Both sender and receiver participate.
Examples: discussions, counselling sessions.
Better for: learning, attitude development, behaviour change.

4. Based on number of people

a. Interpersonal communication

Between two people.
Example: nurse–patient interaction.
Most effective for building trust and understanding.

b. Group communication

Within a small group.
Example: health education sessions, meetings.

c. Mass communication

For large populations.
Examples: radio, TV, newspapers, social media.

5. Based on method/medium

a. Visual communication

Uses visual aids to support learning.
Examples: charts, posters, flashcards, models.

b. Audio communication

Example: radio, audio messages.

c. Audio-visual communication

Combination of sound and visuals.
Examples: videos, TV, multimedia presentations.

d. Telecommunication and internet communication

Digital communication through:

• Email
• Social media
• Online consultations
• Telehealth
• Virtual classes

Useful in modern nursing practice and distance education.

Barriers of communication

Communication does not always flow smoothly. Various factors interfere with the sender, message, channel, or receiver, leading to misunderstanding or incomplete communication. These factors are known as communication barriers.

1. Physiological barriers

These arise from physical problems in the sender or receiver that hinder effective communication.

• Hearing impairment
• Vision problems
• Speech difficulties
• Illness, pain, fatigue

2. Psychological barriers

These are related to the emotional and mental state of individuals, which can affect how messages are sent, received, and interpreted.

• Emotional disturbances
• Anxiety and depression
• Fear, anger, stress
• Low self-esteem

3. Environmental barriers

External conditions in the surroundings that disturb communication.

• Noise, crowding
• Unpleasant environment
• Poor ventilation or lighting
• Improper physical arrangement (seating, distance, room layout)

4. Socio-cultural barriers

Differences in social and cultural backgrounds prevent proper understanding between individuals.

• Differences in religion and cultural beliefs
• Language differences
• Social and economic class gaps
• Traditional norms and values

5. Attitudinal barriers

These arise due to negative attitudes and lack of willingness to communicate.

• Lack of motivation
• Job dissatisfaction
• Biased attitude
• Resistance to change

6. Semantic barriers

These occur when words, symbols, or phrases carry different meanings to different people.

• Use of jargon or technical terms
• Ambiguous or confusing words
• Misinterpretation of message

7. Channel barriers

Problems arising from the medium used for communication.

• Inappropriate channel selection
• Barriers in radio, TV, written documents
• Poor telephone or internet connection

Other common communication barriers

Distortion: Loss or change in meaning during transmission of a message. This leads to misunderstanding.

Problem in message: A message that is unclear, incomplete, or ambiguous becomes difficult to understand.

• Unclear instructions
• Use of vague words
• Lack of proper structure

Lack of communication skills: Poor speaking, listening, or writing skills affect effective communication. • Information overload: When too much information is given at once, the receiver becomes confused and fails to understand the actual message.

Keys to overcome barriers of communication

•  Effective communication (intended meaning)
• Accurate, systematic, clear right word, right person, right time, right place
• Simple clear concise exact and familiar words avoid technical work. Give adequate time.
• Communicate according to need & interest of audience
• Atmosphere (quiet, relax reduce noise)
• Audience must understand given information, so evaluation is necessary to improve communication
• Be a good listener not just hear (LADDER- Look, Ask, Don’t interrupt, Don’t change subject, Express emotion with control, Responsively listen)
• Repeat main point of the delivered information, appreciate audience for positive change
• Speak in normal tone, not raise the voice or shout
• Completeness of message
• Use appropriate channel
• Learning by doing
• Avoid carrying more than one conversation at a time
• Mutual trust and confidence
• Do not make presentation too long (45 minute).

Principles of effective communication

1. Clarity: Message must be clear, simple, and understood by the community or receiver.
2. Conciseness: Communication should be brief and avoid unnecessary details.
3. Completeness: All necessary information must be included for correct understanding.
4. Correctness: Information must be accurate, factual, and free from errors.
5. Courtesy: Communication should be polite, respectful, and culturally sensitive.
6. Consideration: Consider the receiver’s literacy, culture, beliefs, language, and needs.
7. Concreteness: Message should be specific and concrete, not vague.
8. Coherence: Information should be logically arranged and well-organized.
9. Feedback: Confirm that the message has been understood. Essential in CHN.
10. Attention: Gain and maintain the audience’s attention during communication.
11. Timeliness: Information should be given at the right time for maximum impact.
12. Use of appropriate media: Choose proper communication aids (charts, posters, flipbooks, audiovisuals).
13. Empathy: Understand the feelings and emotions of individuals or groups.
14. Credibility: The communicator must be trustworthy; the message should be believable.
15. Participation: Community members should be encouraged to participate in the communication process.

Interview

It is a method of providing health education through the means of questions and answer between the health educator and the learner. The interview is a purposeful face to face interaction between interviewer and interviewee for getting knowledge, attitude and practices on particular issues. In this process interviewee’s knowledge, attitude, feeling and health practices are studied and essential suggestions are given to bring about the positive change.

Aims of interview

• To collect information by gathering facts, opinions, feelings, and experiences from the individual or community.
• To assess health status and needs by identifying the physical, psychological, social, or community health requirements for planning care.
• To establish rapport by building a trusting relationship between the nurse and the patient or community.
• To verify or clarify information by confirming details and removing doubts to ensure accurate understanding.
• To observe behaviour and attitudes by assessing non-verbal cues, emotional status, and overall attitudes.
• To provide health guidance by offering education, advice, and counselling based on the collected information.
• To make decisions by using the collected information to plan care, interventions, or further actions.
• To evaluate outcomes by assessing progress or changes in the person or community over time.

Types/Kinds of the interview

• Structured interview- structured with a format, a certain questionnaire with instructions that is to be followed exactly is known as a structured interview.
• Semi-structured interview- a structured interview guideline but the interviewer has some freedom to reframe, add and clarify question to obtain detail information.
• Unstructured interview- no format and guideline are provided for taking an interview. The interviewer has a freedom to ask a question as per his / her wishes considering the context of an interview

Techniques of successful interview

• Establishing contact: First, contact the interviewee. A prior appointment regarding the time and place of the interview should be arranged. This helps the interviewee feel prepared and gives a sense of satisfaction.
• Starting the interview: After building a good initial relationship, the interview should begin with general discussion related to the topic or problem. The interviewer should create a comfortable atmosphere so that the interviewee can speak freely. The interview should always move from general questions to more specific ones.
• Securing rapport: For an effective interview, good rapport must be developed between the interviewer and interviewee. When rapport is established, hesitation and shyness decrease, and the interviewee feels free to share information openly.
• Recall: During the interview, the interviewee may become emotional, drift away from the main topic, or fall silent. The interviewer should provide enough time for the interviewee to recall and recollect ideas. Sometimes paraphrasing the interviewee’s statements can help refresh their memory.
• Probe questions: If the interviewee knowingly or unknowingly goes off track, the interviewer should bring them back to the main topic by using probing questions. These questions also help clarify points and obtain detailed information relevant to the situation.
• Encouragement: The interviewer should encourage the interviewee from time to time by acknowledging their responses, paraphrasing, or using supportive expressions. Care must be taken to ensure that positive remarks sound genuine and not like flattery.
• Guiding the interview: Sometimes the interviewee may focus excessively on less important topics. In such situations, the interviewer should gently guide the conversation back to the main subject without offending or discouraging the interviewee.
• Recording: The interview should be recorded either on paper or audio/video, but the interviewee must be informed beforehand. If taking notes, the interviewer should jot down only key points while maintaining proper face-to-face contact.
• Closing the interview: Once the interview is complete, the interviewer should inform the interviewee and close the session mutually. The interview should not end abruptly.
•  Reporting: Soon after the interview, the interviewer should compile the findings and prepare a report to submit to the concerned authority.

References

1. Basavanthappa BT. Community Health Nursing. 2nd ed. New Delhi: Jaypee Brothers Medical Publishers; 2017.
2. Park, K. (2024). Park’s Textbook of Preventive and Social Medicine (27th ed.). M/s Banarsidas Bhanot Publishers.
3. Rajinikanth, A. M. (2025). Essential Communication in Nursing. Jaypee Brothers Medical Publishers. ISBN: 9788180617805